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Use your ZIP Code to find your personal plan.
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Find everything you need in the member online account
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HAVE AN ENROLLMENT NEED? SHOP OUR PLANS
-
Our Health Plans
show Our Health Plans menu
-
- About Our Plans
- Our Benefits
- My Health Pays Rewards®
- Coverage Area Map
- Ways to Save
- What is Ambetter Health?
- Shop and Compare Plans
- Find a Doctor
- Washington Healthplanfinder
Use your ZIP Code to find your personal plan.
- See coverage in your area
- Find doctors and hospitals
- View pharmacy program benefits
- View essential health benefits
Find and enroll in a plan that's right for you.
-
-
Join Ambetter Health
show Join Ambetter Health menu
-
- Four easy steps is all it takes
- What you need to enroll
- Special Enrollment Information
-
-
For Members
show For Members menu
-
- Pay Now
- Find a Doctor
- Drug Coverage
- Forms and Materials
- Ways to Pay
- New Members
- Renew Your Plan
- Better Health Center
- The Better Bulletin
- Vision Benefits
- Pharmacy FAQ
- Member News
- Mental Health Resources
Find everything you need in the member online account
- View your claims
- Review your plan benefits
- Print your ID card
- View rewards points total
-
Pre-Auth Tool | Ambetter from Coordinated Care
Pre-Auth Needed?
All attempts are made to provide the most current information on the Pre-Auth Needed Tool. However, this does NOT guarantee payment. Payment of claims is dependent on eligibility, covered benefits, provider contracts, correct coding and billing practices. For specific details, please refer to the provider manual. If you are uncertain that prior authorization is needed, please submit a request for an accurate response.
Vision services, including all services rendered by an Optician, Ophthalmologist, Or Optometrist need to be verified by Envolve Vision
Dental services need to be verified by Envolve Dental
Complex imaging, MRA, MRI, PET, and CT Scans need to be verified by NIA
Musculoskeletal Services need to be verified by Turning Point
Oncology/supportive drugs need to be verified by New Century Health
Services provided by Out-of-Network providers are not covered by the plan. Join Our Network
Are services being performed in the Emergency Department?
Services being performed in the Emergency Department do NOT require prior authorization
Types of Services | YES | NO |
---|---|---|
Are the services being performed or ordered by a non-participating provider? | ||
Is the member being admitted to an inpatient facility? | ||
Are anesthesia services being rendered for dental surgeries? | ||
Is the member receiving Gender Reassignment services? |